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6 Month Results of Topography Guided Repair
1. 6 Month Results of a Wavefront-Topography-Supported Custom Ablation: MEL80 CRS-Master II Dan Z Reinstein MD MA(Cantab) FRCSC 1,2,3,4 Timothy J Archer, MA(Oxon), DipCompSci(Cantab) 1 1. London Vision Clinic, London, UK 2. St. Thomas’ Hospital - Kings College, London, UK 3. Weill Medical College of Cornell University, New York, USA 4. Centre Hospitalier National d’Ophtalmologie, (Pr. Laroche) , Paris, France
2. MEL80: CRS-Master II Target Surface starts at “lowest” point of the irregularities Irregular Surface Target Toric Surface
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9. Example: Zone Expansion Pre Op UCVA 20/20 Rx: +0.75 -0.50 x 11 (20/20) Post Op – 6 Months Post PRK UCVA 20/63 Rx: +1.50 -0.50 x 141 (20/20) Ablation Pattern Topography Difference 8 out of 10 Coma 0.73 µm Sph Ab -8.38 µm HO RMS 0.64 µm Coma 5.30 µm Sph Ab -15.84 µm HO RMS 1.26 µm
10. Example: Decentration Pre Op UCVA 20/20 Rx: +0.25 -0.25 x 33 (20/20) Post Op – 6 Months Post PRK UCVA 20/16 Rx: +0.50 -0.75 x 62 (20/16) Ablation Pattern Topography Difference 8 out of 10 Coma 2.81 µm Sph Ab -3.15 µm HO RMS 0.50 µm Coma 4.49 µm Sph Ab -7.71 µm HO RMS 0.88 µm
11. Example: Decentration Pre Op UCVA 20/100 Rx: -1.88 -0.75 x 28 (20/20) Post Op – 4 Days Post PRK UCVA 20/32 Rx: -0.25 -0.25 x 105 (20/32) Ablation Pattern Topography Difference 8 out of 10 No WASCA post op yet Coma µm Sph Ab µm HO RMS µm Coma 3.61 µm Sph Ab -13.17 µm HO RMS 1.00 µm
12. Example: High Myopia Deep Lamellar Transplant Pre Op UCVA 20/4000 Rx: -8.50 -4.00 x 73 (20/40) Post Op – 3 Months Post PRK UCVA 20/40 Rx: 0.00 -1.25 x 130 (20/32) Ablation Pattern Topography Difference 10 out of 10 Coma 2.81 µm Sph Ab -5.96 µm HO RMS 0.70 µm Coma 1.24 µm Sph Ab -5.61 µm HO RMS 0.92 µm
13. Example: High Myopia Deep Lamellar Transplant Pre Op UCVA 20/400 Rx: +3.50 -7.75 x 70 (20/50) Post Op – 2 Weeks Post LASIK UCVA 20/63 Rx: -0.50 -2.25 x 20 (20/32) Ablation Pattern Topography Difference 9 out of 10 5mm Coma 1.56 µm Sph Ab 3.65 µm HO RMS 0.68 µm Coma 2.15 µm Sph Ab -0.18 µm HO RMS 0.59 µm
14. Example: High Myopia Deep Lamellar Transplant Pre Op UCVA 20/400 Rx: -2.25 -4.75 x 19 (20/32) Post Op – 6 Months Post LASIK UCVA 20/32 Rx: -1.00 sph (20/32) Ablation Pattern Topography Difference 9 out of 10 5mm Coma 5.43 µm Sph Ab -3.23 µm HO RMS 0.72 µm Coma 2.86 µm Sph Ab -2.20 µm HO RMS 0.63 µm
15. Example: Decentration Following RK Pre Op UCVA 20/40 Rx: +1.50 -1.50 x 111 (20/20) Post Op – 4 months Post PRK UCVA 20/16 Rx: +0.25 -1.25 x 120 (20/16) Ablation Pattern Topography Difference 7 out of 10 Coma 2.97 µm Sph Ab -3.69 µm HO RMS 0.48 µm Coma 2.02 µm Sph Ab -11.81 µm HO RMS 0.92 µm
16. Example: Decentration Following RK Pre Op UCVA 20/50 Rx: +3.50 -2.25 x 165 (20/50) Post Op – 6 months Post PRK UCVA 20/50 Rx: +3.00 -2.75 x 45 (20/40) Ablation Pattern Topography Difference Coma 3.88 µm Sph Ab -1.40 µm HO RMS 0.57 µm Coma 2.82 µm Sph Ab -12.04 µm HO RMS 1.16 µm
26. 6 Month Results of a Wavefront-Topography-Supported Custom Ablation: MEL80 CRS-Master II Dan Z Reinstein MD MA(Cantab) FRCSC 1,2,3,4 Timothy J Archer, MA(Oxon), DipCompSci(Cantab) 1 1. London Vision Clinic, London, UK 2. St. Thomas’ Hospital - Kings College, London, UK 3. Weill Medical College of Cornell University, New York, USA 4. Centre Hospitalier National d’Ophtalmologie, (Pr. Laroche) , Paris, France Thank You
Editor's Notes
The MEL80 topography system is designed to re-shape an irregular corneal surface and optimize the new shape to a low aberration aspheric cornea. The postoperative outcome may be spherical or toric. The target toric surface will be fixed at the “lowest” point of the irregularities because the cornea has to be re-shaped by tissue removal rather than tissue addition
The MEL80 topography system uses proprietary algorithms combining the topographic lower and higher order wavefront with the ocular lower order aberrations. This algorithm provides much improved control of the refraction for topography guided treatments, which has been one of the main challenges of previous systems
The CRS-Master II can also treat a refraction as well as the surface irregularities The CRS-Master II algorithm (2) – treating irregularities and ocular refraction The algorithm calculates the refraction to be treated from the manifest and intended refraction entered into the CRS-Master software The target toric surface is calculated depending on the nature of the irregularities and the intended post-operative refraction The ablation is calculated from the difference between the pre-operative topography and target aspheric surface
Lost 1 line: Parkyn – Haze
There was a statistically significantly reduction of Higher Order RMS
There was a statistically significantly reduction of Seidel Spherical Aberration
There were no significant differences for contrast sensitivity
